Obstructive Sleep Apnea and Major Osteoporotic Fractures Risk

<bold>Background:</bold> In Obstructive sleep apnea (OSA), as a result of different direct and indirect mechanisms, bone metabolism is impaired. The changes in bone architecture lead to an increased fracture risk. <bold>Aim:</bold> to evaluate the risk factors for major osteoporosis fractures in patients with newly diagnosed OSA. <bold>Materials and methods:</bold> prospective study, including 130 patients with newly diagnosed OSA and 67 participants without OSA. Anthropometric, laboratory, instrumental and study tests were performed. <bold>Results:</bold> Vitamin D <17.66 nmol/l (OR 6.718, p=0.002), minimal oxygen saturation <70.75% (OR 3.882, p=0.012), average oxygen desaturation > 10.65% (OR 1.695, p=0.003) and OMORT score> 6points (OR 1.009, p=0.009) are associated with greater probability of major osteoporotic fractures. The vitamin D level ≤ 17.66nmol/l has a specificity of 71.7 % and sensitivity of 98.8 % for predicting major osteoporotic fractures (AUC: 0.957, 95% CI: 0.933-0.982, p=0.001). The risk of major osteoporotic fractures is low when the lowest oxygen saturation is ≥70.75 mmHg (AUC: 0.717, 95% CI: 0.610-0.823, p=0.001; 73.9% sensitivity and 71.4% specificity) and when the average oxygen desaturation is ≤10.65% (AUC: 0.645, 95% CI: 0.534-0.757, p=0.015; 62.2% sensitivity and 67.3% specificity). One model predicts the major osteoporotic fractures risk with a probability of 82.14% - combination of vitamin D<17.66 nmol/l, minimal oxygen saturation < 70.75mmHg and OMORT score> 6points. <bold>Conclusion:</bold> OSA patients are at higher risk for major osteoporotic fractures. The values of vitamin D, the minimal oxygen saturation and the OMORT test for osteoporosis can predict the risk of major osteoporotic fractures.